The influence of partner's behavior on health behavior change: the English Longitudinal Study of Ageing

JAMA Intern Med. 2015 Mar;175(3):385-92. doi: 10.1001/jamainternmed.2014.7554.


Importance: Couples are highly concordant for unhealthy behaviors, and a change in one partner's health behavior is often associated with a change in the other partner's behavior. However, no studies have explicitly compared the influence of having a partner who takes up healthy behavior (eg, quits smoking) with one whose behavior is consistently healthy (eg, never smokes).

Objective: To examine the influence of partner's behavior on making positive health behavior changes.

Design, setting, and participants: We used prospective data from married and cohabiting couples (n, 3722) participating in the English Longitudinal Study of Ageing, a large population-based cohort of older adults (≥50 years). Studying men and women who had unhealthy behaviors in 3 domains at baseline (ie, smoking, physically inactive, or overweight/obese), we used logistic regression analysis to examine the influence of the partner's behavior in the same domain on the odds of positive health behavior change over time.

Main outcomes and measures: Smoking cessation, increased physical activity, and 5% weight loss or greater.

Results: Across all domains, we found that when one partner changed to a healthier behavior (newly healthy), the other partner was more likely to make a positive health behavior change than if their partner remained unhealthy (smoking: men 48% vs 8%, adjusted odds ratio [OR], 11.82 [95% CI, 4.84-28.90]; women 50% vs 8%, OR, 11.23 [4.58-27.52]) (physical activity: men 67% vs 26%, OR, 5.28 [3.70-7.54]; women 66% vs 24%, OR, 5.36 [3.74-7.68]) (weight loss: men 26% vs 10%, OR, 3.05 [1.96-4.74]; women 36% vs 15%, OR, 3.08 [1.98-4.80]). For smoking and physical activity, having a consistently healthy partner also predicted positive change, but for each domain, the odds were significantly higher in individuals with a newly healthy partner than those with a consistently healthy partner (smoking: men OR, 3.08 [1.43-6.62]; women OR, 5.45 [2.44-12.16]) (physical activity: men OR, 1.92 [1.37-2.70]; women OR, 1.84 [1.33-2.53]) (weight loss: men OR, 2.28 [1.36-3.84]; women OR, 2.86 [1.55-5.26]).

Conclusions and relevance: Men and women are more likely to make a positive health behavior change if their partner does too, and with a stronger effect than if the partner had been consistently healthy in that domain. Involving partners in behavior change interventions may therefore help improve outcomes.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Female
  • Health Behavior*
  • Humans
  • Logistic Models
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Motor Activity
  • Smoking Cessation / psychology
  • Spouses / psychology*
  • Weight Loss